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Japanese Journal of Ophthalmology

, Volume 62, Issue 1, pp 24–30 | Cite as

Incidence of endophthalmitis and the perioperative practices of cataract surgery in Japan: Japanese Prospective Multicenter Study for Postoperative Endophthalmitis after Cataract Surgery

  • Tomoyuki Inoue
  • Toshihiko Uno
  • Norio Usui
  • Shinichiro Kobayakawa
  • Kiyoshi Ichihara
  • Yuichi Ohashi
  • On behalf of the Japanese Prospective Multicenter Study Group for Postoperative Endophthalmitis after Cataract Surgery
Clinical Investigation

Abstract

Purpose

To prospectively survey the incidence of endophthalmitis following cataract surgery and investigate the current perioperative practices in Japan.

Methods

Patients who underwent cataract surgery from January 2012 to December 2013 were included. Information on perioperative practices were recorded prospectively. Clinical characteristics were examined in cases with endophthalmitis.

Results

A total of 63,244 patients who underwent cataract surgery in 205 facilities were enrolled. The detailed information about the current perioperative scenario surrounding cataract surgery in Japan was evaluated for the preoperative, intraoperative, and postoperative practices, i.e., patient background, prophylactic antibiotic regimen, modes of disinfection or disinfectant use, preoperative procedure, surgical method, surgical materials, surgical complication, or others. Postoperative endophthalmitis developed in 25 patients within 8 weeks postoperatively (incidence 0.04%). However, since outbreaks of toxic anterior segment syndrome (TASS) after implantation of intraocular lenses contaminated with aluminum (HOYA iSert 251 and 255) were reported, 10,261 cases implanted with the lenses had been excluded (as having a risk for non-infectious late-onset TASS). In the remaining 52,983 cases, postoperative endophthalmitis developed in 13 cases within 8 weeks postoperatively (incidence 0.025%).

Conclusions

This prospective survey identified the current perioperative practices representing cataract surgery and the incidence of endophthalmitis following cataract surgery (0.025%) in Japan. We believe this information can serve as a guide for future improvement in risk-reduction strategies.

Keywords

Cataract surgery Endophthalmitis Incidence Infection Perioperative information 

Notes

Acknowledgements

The authors would like to thank Medical International for English language review.

Conflicts of interest

T. Inoue, None; T. Uno, None; N. Usui, None; S. Kobayakawa, None; K. Ichihara, None; Y. Ohashi, None.

Supplementary material

10384_2017_545_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 kb)
10384_2017_545_MOESM2_ESM.docx (25 kb)
Supplementary material 2 (DOCX 25 kb)

References

  1. 1.
    Ng JQ, Morlet N, Pearman JW, Constable IJ, McAllister IL, Kennedy CJ, et al. Management and outcomes of postoperative endophthalmitis since the endophthalmitis vitrectomy study: the Endophthalmitis Population Study of Western Australia (EPSWA)’s fifth report. Ophthalmology. 2005;112:1199–206.CrossRefPubMedGoogle Scholar
  2. 2.
    Hatch WV, Cernat G, Wong D, Devenyi R, Bell CM. Risk factors for acute endophthalmitis after cataract surgery: a population-based study. Ophthalmology. 2009;116:425–30.CrossRefPubMedGoogle Scholar
  3. 3.
    Olson RJ. Reducing the risk of postoperative endophthalmitis. Surv Ophthalmol. 2004;49:S55–61.CrossRefPubMedGoogle Scholar
  4. 4.
    Li J, Morlet N, Ng JQ, Semmens JB. Knuiman MW; Team EPSWA. Significant nonsurgical risk factors for endophthalmitis after cataract surgery: EPSWA fourth report. Investig Ophthalmol Vis Sci. 2004;45:1321–8.CrossRefGoogle Scholar
  5. 5.
    Lundström M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after cataract surgery: a nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology. 2007;114:866–70.CrossRefPubMedGoogle Scholar
  6. 6.
    Artzén D, Lundström M, Behndig A, Stenevi U, Lydahl E, Montan P. Capsule complication during cataract surgery: case–control study of preoperative and intraoperative risk factors: Swedish Capsule Rupture Study Group report 2. J Cataract Refract Surg. 2009;35:1688–93.CrossRefPubMedGoogle Scholar
  7. 7.
    Wejde G, Montan P, Lundström M, Stenevi U, Thorburn W. Endophthalmitis following cataract surgery in Sweden: national prospective survey 1999–2001. Acta Ophthalmol Scand. 2005;83:7–10.CrossRefPubMedGoogle Scholar
  8. 8.
    Barry P, Seal DV, Gettinby G, Lees F, Peterson M, Revie CW, ESCRS Endophthalmitis Study Group. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg. 2006;32:407–10.CrossRefPubMedGoogle Scholar
  9. 9.
    Sandvig KU, Dannevig L. Postoperative endophthalmitis: establishment and results of a national registry. J Cataract Refract Surg. 2003;29:1273–80.CrossRefPubMedGoogle Scholar
  10. 10.
    West ES, Behrens A, McDonnell PJ, Tielsch JM, Schein OD. The incidence of endophthalmitis after cataract surgery among the US Medicare population increased between 1994 and 2001. Ophthalmology. 2005;112:1388–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Oshika T, Hatano H, Kuwayama Y, Ogura Y, Ohashi Y, Oki K, et al. Incidence of endophthalmitis after cataract surgery in Japan. Acta Ophthalmol Scand. 2007;85:848–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Suzuki T, Ohashi Y, Oshika T, Goto H, Hirakata A, Fukushita K, et al. Outbreak of late-onset toxic anterior segment syndrome after implantation of 1-piece intraocular lenses. Am J Ophthalmol. 2015;159:934–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Speaker MG, Milch FA, Shah MK, Eisner W, Kreiswirth BN. Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology. 1991;98:639–49.CrossRefPubMedGoogle Scholar
  15. 15.
    Ciulla TA, Starr MB, Masket S. Bacterial endophthalmitis prophylaxis for cataract surgery: an evidence-based update. Ophthalmology. 2002;109:13–24.CrossRefPubMedGoogle Scholar
  16. 16.
    Deramo VA, Lai JC, Fastenberg DM, Udell IJ. Acute endophthalmitis in eyes treated prophylactically with gatifloxacin and moxifloxacin. Am J Ophthalmol. 2006;142:721–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Inoue Y, Usui M, Ohashi Y, Shiota H, Yamazaki T, Preoperative Disinfection Study Group. Preoperative disinfection of the conjunctival sac with antibiotics and iodine compounds: a prospective randomized multicenter study. Jpn J Ophthalmol. 2008;52:151–61.CrossRefPubMedGoogle Scholar
  18. 18.
    Jabbarvand M, Hashemian H, Khodaparast M, Jouhari M, Tabatabaei A, Rezaei S. Endophthalmitis occurring after cataract surgery: outcomes of more than 480 000 cataract surgeries, epidemiologic features, and risk factors. Ophthalmology. 2016;123:295–301.CrossRefPubMedGoogle Scholar
  19. 19.
    Mamalis N, Edelhauser HF, Dawson DG, Chew J, LeBoyer RM, Werner L. Toxic anterior segment syndrome. J Cataract Refract Surg. 2006;32:324–33.CrossRefPubMedGoogle Scholar
  20. 20.
    Holland SP, Morck DW, Lee TL. Update on toxic anterior segment syndrome. Curr Opin Ophthalmol. 2007;18:4–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Friling E, Lundström M, Stenevi U, Montan P. Six-year incidence of endophthalmitis after cataract surgery: Swedish national study. J Cataract Refract Surg. 2013;39:15–21.CrossRefPubMedGoogle Scholar
  22. 22.
    Sheng Y, Sun W, Gu Y, Lou J, Liu W. Endophthalmitis after cataract surgery in China, 1995–2009. J Cataract Refract Surg. 2011;37:1715–22.CrossRefPubMedGoogle Scholar
  23. 23.
    Mollan SP, Gao A, Lockwood A, Durrani OM, Butler L. Postcataract endophthalmitis: incidence and microbial isolates in a United Kingdom region from 1996 through 2004. J Cataract Refract Surg. 2007;33:265–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Hatch WV, Cernat G, Wong D, Devenyi R, Bell CM. Risk factors for acute endophthalmitis after cataract surgery: a population-based study. Ophthalmology. 2009;116:425–30.CrossRefPubMedGoogle Scholar
  25. 25.
    Freeman EE, Roy-Gagnon MH, Fortin E, Gauthier D, Popescu M, Boisjoly H. Rate of endophthalmitis after cataract surgery in Quebec, Canada, 1996–2005. Arch Ophthalmol. 2010;128:230–4.CrossRefPubMedGoogle Scholar
  26. 26.
    Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. 2005;123:613–20.CrossRefPubMedGoogle Scholar
  27. 27.
    Endophthalmitis Study Group, European Society of Cataract & Refractive Surgeons. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33:978–88.CrossRefGoogle Scholar
  28. 28.
    Barry P, Seal DV, Gettinby G, Lees F, Peterson M, Revie CW, ESCRS Endophthalmitis Study Group. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study. J Cataract Refract Surg. 2006;32:407–10.CrossRefPubMedGoogle Scholar
  29. 29.
    Delyfer MN, Rougier MB, Leoni S, Zhang Q, Dalbon F, Colin J, et al. Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg. 2011;37:271–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol. 1995;113:1479–96.CrossRefGoogle Scholar
  31. 31.
    Fisch A, Salvanet A, Prazuck T, Forestier F, Gerbaud L, Coscas G, et al. Epidemiology of infective endophthalmitis in France. The French Collaborative Study Group on Endophthalmitis. Lancet. 1991;338:1373–6.PubMedGoogle Scholar
  32. 32.
    Lalwani GA, Flynn HW Jr, Scott IU, Quinn CM, Berrocal AM, Davis JL, et al. Acute-onset endophthalmitis after clear corneal cataract surgery (1996–2005). Clinical features, causative organisms, and visual acuity outcomes. Ophthalmology. 2008;115:473–6.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2017

Authors and Affiliations

  • Tomoyuki Inoue
    • 1
  • Toshihiko Uno
    • 2
  • Norio Usui
    • 3
  • Shinichiro Kobayakawa
    • 4
  • Kiyoshi Ichihara
    • 5
  • Yuichi Ohashi
    • 6
  • On behalf of the Japanese Prospective Multicenter Study Group for Postoperative Endophthalmitis after Cataract Surgery
  1. 1.Tane Memorial Eye HospitalOsakaJapan
  2. 2.Shirai Eye HospitalKagawaJapan
  3. 3.Division of OphthalmologyShinkawabashi HospitalKanagawaJapan
  4. 4.Department of OphthalmologyNippon Medical School Tama Nagayama HospitalTokyoJapan
  5. 5.Department of Clinical Laboratory Science, Faculty of Health SciencesYamaguchi University Graduate School of MedicineYamaguchiJapan
  6. 6.Ehime UniversityEhimeJapan

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